Conversion of clinically isolated syndrome to multiple sclerosis: a prospective multi-center study in Eastern India.

BACKGROUND: In White populations more than 60% of clinically isolated syndrome (CIS) convert to multiple sclerosis (MS) on a long-term follow-up; several predictors for conversion have been identified. OBJECTIVE: This study aimed to determine the conversion rate and the predictors of conversion from CIS to MS (McDonald 2010) among Indians. The other objective was to evaluate the diagnostic accuracy of the new McDonald 2017 criteria in prediction of a second clinical attack. METHODS: Clinical and demographic data of CIS cohorts were collected. Baseline investigations included cerebrospinal magnetic resonance imaging (MRI) with contrast and cerebrospinal fluid (CSF) testing for oligoclonal band (OCB). Follow-up clinical and MRI examinations were performed annually for at least 24 months. RESULTS: Of the 82 subjects (age range 15-58 years), 36 (43.9%) converted to MS; 31/82 (37.8%) converted in 24 months. The predictors for conversion were earlier age of onset, CSF-OCB, cerebral MRI T2 lesion count, and periventricular and juxtacortical location of lesions. Twenty-two (26.83%) CIS fulfilled the McDonald MS 2017 criteria at baseline. CONCLUSION: In this first prospective study of CIS in India, the risk factors for conversion are similar but the conversion rate to MS is lower than that in the western nations.

Decontamination of coal mine effluent generated at the Rajrappa coal mine using phytoremediation technology.

Toxicity of the effluent generated at the Rajrappa coal mine complex under the Central Coalfields Limited (CCL, a subsidiary of Coal India Limited) in Jharkhand, India was investigated. The concentrations (mg L-1) of all the toxic metals (Fe, Mn, Ni, Zn, Cu, Pb, Cr, and Cd) in the coal mine effluent were above the safe limit suggested by the Environmental Protection Agency (EPA 2003). Among these, Fe showed the highest concentration (18.21 ± 3.865), while Cr had the lowest effluent concentration (0.15 ± 0.014). Efforts were also made to detoxify the effluent using two species of aquatic macrophytes namely "'Salvinia molesta and Pistia stratiotes." After 10 days of phytoremediation, S. molesta removed Pb (96.96%) > Ni (97.01%) > Cu (96.77%) > Zn (96.38%) > Mn (96.22%) > Fe (94.12%) > Cr (92.85%) > Cd (80.99%), and P. stratiotes removed Pb (96.21%) > Fe (94.34%) > Ni (92.53%) > Mn (85.24%) > Zn (79.51%) > Cr (78.57%) > Cu (74.19%) > Cd (72.72%). The impact of coal mine exposure on chlorophyll content showed a significant decrease of 42.49% and 24.54% from control values in S. molesta and P. stratiotes, respectively, perhaps due to the damage inflicted by the toxic metals, leading to the decay of plant tissues.

Evaluation of pollution of Ganga River water using fish as bioindicator.

Ganga River, life line of millions of people got heavily polluted due to uncontrolled anthropogenic activities. To monitor the effect of pollution of the river on its aquatic life, a field study was conducted by analyzing the different biomarker enzymes and biochemical parameters in the various tissues (muscles, liver, gills, kidney, brain, and skin) of the Indian major carp Labeo rohita collected from the River Ganga from different study sites of Varanasi district. Activities of antioxidant enzymes, e.g., superoxide dismutase, catalase, and level of lipid peroxidation were found to be higher in the fish collected from the river showing pollutant-induced oxidative stress in the fish. Disturbed health status of the river fish was also manifested by increased activities of aspartate amino transferase, alanine amino transferase, and alkaline phosphatase. Concentration of nutritionally important biomolecules (proteins, lipids, and moisture) and energy value were also found to be significantly lower in the tissues of the River fish indicating its decreased nutritional value due to oxidative stress caused by different pollutants.

Arsenic induced hematological and biochemical responses in nutritionally important catfish Clarias batrachus (L.).

The impact of sublethal toxicity of sodium arsenite on hematological and certain biochemical parameters of the fresh water catfish Clarias batrachus has been analyzed following exposure of sublethal concentration (1 mg/L; 5% of LC50 value) of sodium arsenite for 10, 30, 45, and 60 days. Arsenic bioaccumulation in the blood tissue of the fish increased progressively with increased period of exposure. The values of total erythrocyte count (TECs), total leucocytes count (TLCs), hemoglobin concentration, and packed cell volume (PCV) 1.40 ± 0.03 × 106/mm3, 174.83 ± 2.74 × 103/mm3, 5.01 ± 0.26 g/100 ml, 25.00 ± 1.06 were observed respectively at the end of 60 days of exposure. The results of hematological indices were found to be 179.23 ± 8.81fl/cell for mean corpuscular volume (MCV), 35.92 ± 1.89 pg/cell for mean corpuscular hemoglobin (MCH) and 20.17 ± 1.12 g/dl for mean corpuscular hemoglobin concentration (MCHC). The present findings are clearly indicating severe fish anemia due to the arsenic salt exposure. The continued arsenic toxicity results in decreased serum protein concentration that might be a cause for the loss of weight as well as weakness in the fish.

Burden among Parkinson's disease care givers for a community based study from India.

Aim was to analyze predictors of burden among primary caregivers (CGs) of Indian Parkinson's disease (PD) patients. 150 PD patients were administered using Unified Parkinson's Disease Rating Scale (UPDRS), Hoehn and Yahr Scale (H&Y), Montgomery Asberg Depression Rating Score (MADRS) and Mini Mental State Examination (MMSE) in this cross-sectional evaluation study. CG burden was assessed by Caregiver's Burden Scale (CBS), Hospital Anxiety and Depression Scale (HADS), SF-36 and 20-item Burden Assessment Schedule (BAS). Linear regression methods were used to evaluate factors contributing to burden and stress. Mean age of CG was 50.38±16.04 (range: 25-83 yrs). Marital status of CGs was noted to have significant relationship with CBS score (F=9.525, P<0.0001). Siblings (brother/sister) reported the highest CBS score while the wives reported the least. Correlations were strong between CBS and HADS anxiety (r=0.228, P=0.0048) and HADS depression (r=0.2172, P=0.0076). High correlations were found in caregiving duration, patients' stage of illness and motor disability among all the scales (CBS, HADS, SF36) determined. Step-wise regression analysis showed UPDRS (beta=1.364-0.202 ranging among all scales) and H&Y stages (beta=2.786-7.257) to have the strongest influence on CGs. CGs of patients with depression (MADRS: P=0.007 (SF36 mental) and dementia (MMSE: P=0.01) experienced greater stress. Social and financial status was disrupted in ~60% to 80% of the CGs. Motor imbalances with disability of PD patients and severity of disease are the main factors contributing to burden and stress in CGs.

Epidemiology of epilepsy and its burden in Kolkata, India.

BACKGROUND: Disability-adjusted life year (DALY) is a time-based measure of disease burden incorporating both disability and mortality. Our study aimed to determine the DALY lost from epilepsy in an Indian metropolis. METHODS: A population-based prospective study on epilepsy was conducted over 5 years (2003-8) in Kolkata, India, on randomly selected 100,802 subjects (males 53,209, females 47,593) to assess prevalence as well as to capture incident cases of epilepsy and those incident cases that died. Standard case definitions were used. The data were used to estimate years of life lost (YLL) due to premature mortality, years of life lived with disability (YLD), and DALY, utilizing the prevalence-based Global Burden of Disease (GBD) 2010 approach. Age- and gender-specific figures were computed. RESULTS: During 2003-2004, a total of 476 subjects with active epilepsy were detected and the age-adjusted prevalence rate was 4.71 per 1000. Over 5 years, there were 197 incident cases of epilepsy of whom 26 died. The age-adjusted annual incidence rate of epilepsy was 38.3 per 100,000. The all-cause standardized mortality rate (SMR) of epilepsy was 2.4. The burden of epilepsy in the year 2007-8 revealed the overall YLL was 755 per 100,000, and the overall YLD ranged from 14.45 to 31.0 per 100,000 persons depending on the clinical severity of the epilepsy. Both YLL and YLD values were higher in males than in females. The overall DALY lost due to epilepsy in 2007-8 was found to be 846.96 (males 1183.04, females 463.81) per 100,000. CONCLUSIONS: This is the first study in India to determine the DALY of epilepsy using GBD 2010. The results reveal a substantial burden of epilepsy in our setting. Similar such studies are needed in other parts of India in both urban and rural settings.

Contamination of metals in different tissues of rohu (Labeo rohita, Cyprinidae) collected from the Indian River Ganga.

In the present paper, accumulation of zinc (Zn), iron (Fe), copper (Cu), chromium (Cr), nickel (Ni), manganese (Mn) and lead (Pb) was determined in different tissues (skin, muscles, liver, gills, kidney and brain) of rohu (Labeo rohita) collected from the River Ganga in Varanasi, India. Concentrations of Cu (except gills), Fe and Cr (except brain for Cr) in most of the tissues were above the permissible safe limits for human consumption suggested by the Food and Agricultural Organization (FAO 1983). Concentrations of all metals were higher in River Ganga fish than those from the University fish farm. With the exception of Zn in skin, muscle and brain tissue, the studied metals were bioaccumulated in all tissues. The total metal accumulation or metal pollution index was highest in liver (20.8 ± 0.50) followed by kidney (16.8 ± 0.44), gills (15.2 ± 0.15), muscles (12.1 ± 0.08), skin (10.5 ± 0.53) and brain (7.0 ± 0.02).

Contamination of the River Ganga and its toxic implication in the blood parameters of the major carp Labeo rohita (Ham).

A field study was conducted to examine different physicochemical properties of water and various haematological and biochemical parametres of the fish Labeo rohita collected from the Ganga River (National river of India) at Varanasi district, India. The water was found to be greatly contaminated with a number of dissolved metals (Fe, Cr, Zn, Cu, Mn, Ni and Pb) whose concentrations were above the safe limits suggested by Bureau of Indian Standard (BIS 1991) for drinking water (Fe, 1,353.33 %; Cr, 456 %; Mn, 553.33 %; Ni, 4,490 % and Pb, 1,410 %). The metal accumulation in the fish blood was very high (Fe, 2,408 %; Cr, 956.57 %; Zn, 464.90 %; Cu, 310.57 %; Mn, 1,115.48 %) in comparison to the control fish maintained under strict quality control. Lower values of the various haematological parameters (total erythrocytes count, haemoglobin, haematocrit, mean corpuscular volume and O2-carrying capacity) in the river fish in comparison to the control indicate toxic manifestation exerted by the contaminated river water on the fish. The higher level of total leucocytes count further illustrates stressed condition of the river fish. The toxic impact of the Ganga water is also expressed in the fish by the presence of higher levels of cholesterol, glucose, elevated activities of the enzymes aspartate amino transferase and alanine amino transferase, and lowered protein concentration.

Phytoremediation of the toxic effluent generated during recovery of precious metals from polymetallic sea nodules.

Recovery of metals from the polymetallic sea nodules at the pilot plant at National Metallurgical Laboratory, Jamshedpur, India has generated a highly toxic effluent. This effluent contains several metals like Mn, Cu, Zn, Fe, Pb, Cr, and Cd that pollute the neighboring water bodies when discharged. Hence detoxification of this effluent was practiced using two plants: Lemna minor and Azolla pinnata for 7 days. During investigation A. pinnata removed 96% of Mn, 97% of Cu, 98% of Zn, 70% of Fe, 96% of Pb, 93% of Cr, 78% of Cd, and was comparatively more effective than L. minor which removed 94% of Mn, 86% of Cu, 62% of Zn, 74% of Fe, 84% of Pb, 63% of Cr, 78% of Cd. During the 7 days of experiment chlorophyll content decreased by 51% and 59% in A. pinnata and L. minor respectively. Based on our findings we can suggest that these two plants have wide range of metal retention potentialities hence can be of routine use for purification of toxic effluents.

Study of sodium arsenite induced biochemical changes on certain biomolecules of the freshwater catfish Clarias batrachus

Toxic impact of sublethal concentration (1 mg/L; 5% of 96h LC50 value) of sodium arsenite (NaAsO2) on certain biomolecules (proteins, nucleic acids, lipids, and glycogen) of five tissue components (muscles, liver, brain, skin, and gills) of the freshwater catfish Clarias batrachus was analysed. The important toxic manifestations include marked decrease in the concentration of proteins (21.72-45.42% in muscles; 3.42-53.94% in liver; 15.39-45.42% in brain; 15.40-4.00% in skin and 11.35-64.13% in gills), DNA (0.55-22.95% in muscles; 8.33-14.06% in liver; 5.30-18.40% in brain; 13.57-52.80% in skin; and 12.38-31.01% in gills), RNA (42.68-76.16% in muscles; 10.68-39.75% in liver; 5.66-29.05% in brain; 7.72-27.93% in skin and 21.47-44.38% in gills) and glycogen (24.00-51.72% in muscles; 49.11-72.45% in liver; 11.49-26.03% in brain; 26.13-38.05% in skin and 17.80-37.97% in gills). Excepting liver where the lipid content increases (15.82-24.13%), the fat content also showed depletion in their concentration (10.40-29.83% in muscles; 8.30-34.45% in brain; 8.94-31.47% in skin and 12.75-28.86% in gills), in the rest of the organ systems.

Foi analisado o impacto tóxico da concentração subletal (1 mg/L; 5% do valor de LC50 de 96h) do arsenito de sódio (NaAsO2) sobre certas biomoléculas (proteinas, ácidos nucleicos, lipídios e glicogênio) de cinco tecidos (músculos, fígado, cérebro, pele e brânquias) do bagre Clarias batrachus. As manifestações tóxicas importantes incluiram o decréscimo acentuado na concentração de proteinas (21,72-45,42% nos músculos; 3,42-53,94% no fígado; 15,39-45,42% no cérebro; 15,40-4,00% na pele e 11,35-64,13% nas brânquias), DNA (0,55-22,95% nos músculos; 8,33-14,06% no fígado; 5,30-18,40% no cérebro; 13,57-52,80% na pele e 12,38-31,01% nas brânquias), RNA (42,68-76,16% nos músculos; 10,68-39,75% no fígado; 5,66-29,05% no cérebro; 7,72-27,93% na pele e 21,47-44,38% nas brânquias) e glicogênio (24,00-51,72% nos músculos; 49,11-72,45% no fígado; 11,49-26,03% no cérebro; 26,13-38,05% na pele e 17,80-37,97% nas brânquias). Excetuando o fígado onde o conteúdo de lipídeos aumentou (15,82-24,13%), houve uma depleção na concentração de lipídeos no restante dos sistemas orgânicos (10,40-29,83% nos músculos; 8,30-34,45% no cérebro; 8,94-31,47% na pele e 12,75-28,86% nas brânquias).

Study of sodium arsenite induced biochemical changes on certain biomolecules of the freshwater catfish Clarias batrachus

Toxic impact of sublethal concentration (1 mg/L; 5% of 96h LC50 value) of sodium arsenite (NaAsO2) on certain biomolecules (proteins, nucleic acids, lipids, and glycogen) of five tissue components (muscles, liver, brain, skin, and gills) of the freshwater catfish Clarias batrachus was analysed. The important toxic manifestations include marked decrease in the concentration of proteins (21.72-45.42% in muscles; 3.42-53.94% in liver; 15.39-45.42% in brain; 15.40-4.00% in skin and 11.35-64.13% in gills), DNA (0.55-22.95% in muscles; 8.33-14.06% in liver; 5.30-18.40% in brain; 13.57-52.80% in skin; and 12.38-31.01% in gills), RNA (42.68-76.16% in muscles; 10.68-39.75% in liver; 5.66-29.05% in brain; 7.72-27.93% in skin and 21.47-44.38% in gills) and glycogen (24.00-51.72% in muscles; 49.11-72.45% in liver; 11.49-26.03% in brain; 26.13-38.05% in skin and 17.80-37.97% in gills). Excepting liver where the lipid content increases (15.82-24.13%), the fat content also showed depletion in their concentration (10.40-29.83% in muscles; 8.30-34.45% in brain; 8.94-31.47% in skin and 12.75-28.86% in gills), in the rest of the organ systems.

Foi analisado o impacto tóxico da concentração subletal (1 mg/L; 5% do valor de LC50 de 96h) do arsenito de sódio (NaAsO2) sobre certas biomoléculas (proteinas, ácidos nucleicos, lipídios e glicogênio) de cinco tecidos (músculos, fígado, cérebro, pele e brânquias) do bagre Clarias batrachus. As manifestações tóxicas importantes incluiram o decréscimo acentuado na concentração de proteinas (21,72-45,42% nos músculos; 3,42-53,94% no fígado; 15,39-45,42% no cérebro; 15,40-4,00% na pele e 11,35-64,13% nas brânquias), DNA (0,55-22,95% nos músculos; 8,33-14,06% no fígado; 5,30-18,40% no cérebro; 13,57-52,80% na pele e 12,38-31,01% nas brânquias), RNA (42,68-76,16% nos músculos; 10,68-39,75% no fígado; 5,66-29,05% no cérebro; 7,72-27,93% na pele e 21,47-44,38% nas brânquias) e glicogênio (24,00-51,72% nos músculos; 49,11-72,45% no fígado; 11,49-26,03% no cérebro; 26,13-38,05% na pele e 17,80-37,97% nas brânquias). Excetuando o fígado onde o conteúdo de lipídeos aumentou (15,82-24,13%), houve uma depleção na concentração de lipídeos no restante dos sistemas orgânicos (10,40-29,83% nos músculos; 8,30-34,45% no cérebro; 8,94-31,47% na pele e 12,75-28,86% nas brânquias).

Epidemiology of Parkinson disease in the city of Kolkata, India: a community-based study.

OBJECTIVE: No well-designed longitudinal study on Parkinson disease (PD) has been conducted in India. Therefore, we planned to determine the prevalence, incidence, and mortality rates of PD in the city of Kolkata, India, on a stratified random sample through a door-to-door survey. METHOD: This study was undertaken between 2003 to 2007 with a validated questionnaire by a team consisting of 4 trained field workers in 3 stages. Field workers screened the cases, later confirmed by a specialist doctor. In the third stage, a movement disorders specialist undertook home visits and reviewed all surviving cases after 1 year from last screening. Information on death was collected through verbal autopsy. A nested case-control study (1:3) was also undertaken to determine putative risk factors. The rates were age adjusted to the World Standard Population. RESULT: A total population of 100,802 was screened. The age-adjusted prevalence rate (PR) and average annual incidence rate were 52.85/100,000 and 5.71/100,000 per year, respectively. The slum population showed significantly decreased PR with age compared with the nonslum population. The adjusted average annual mortality rate was 2.89/100,000 per year. The relative risk of death was 8.98. The case-control study showed that tobacco chewing protected and hypertension increased PD occurrence. CONCLUSION: This study documented lower prevalence and incidence of PD as compared with Caucasian and a few Oriental populations. The mortality rates were comparable. The decreased age-specific PR among slum populations and higher relative risk of death need further probing.

Plasma levels of lipid peroxides in patients with Parkinson's disease.

Oxidative stress is implicated as a major factor for nigral neuronal cell death. Metabolic failure in antioxidant mechanisms could hypothetically facilitate the chemical processes that lead to lipid peroxidation. To elucidate whether elevated lipid peroxidation rates might increase risk of developing Parkinson's disease (PD), the Authors determined plasma levels of malondialdehyde (MDA) in 80 PD patients and 80 controls. There was a significant difference between the plasma MDA levels of PD patients and controls (7.48 +/- 1.55 vs 5.1 +/- 1.26 nmol/ml). Plasma MDA levels were inversely related to the age of the PD patients (r = -0.46; p < 0.01) and age of onset but in the control group, no such correlation was observed between the plasma MDA and age. However, there was no significant correlation between plasma MDA levels and the duration of disease, Hoehn and Yahr stages and the Unified Parkinson's Disease Rating Scale (UPDRS). Thus, the results suggest that high plasma lipid peroxidation rates might contribute as a risk factor for PD in West Bengal.

Prevalence of essential tremor in the city of Kolkata, India: a house-to-house survey.

BACKGROUND AND PURPOSE: Prevalence of essential tremor (ET), one of the most common movement disorders, has not been properly evaluated amongst heterogeneous population in India. METHODS: We conducted a cross-sectional epidemiological study on the prevalence of ET in a randomly stratified population in the metropolitan city of Kolkata (erstwhile Calcutta), India, by a field team headed by a specialist doctor. A two-stage house-to-house survey was carried out with a validated screening instrument. RESULTS: A population of 52377 was screened and a total of 184 cases of ET were identified as per pre-defined criteria and the prevalence rate adjusted to World Standard Population was 3.95 per 1000 (95% CI: 3.40-4.56). Age-specific prevalence showed increasing prevalence with aging. Sex-specific prevalence did not show significant difference between men and women. Socio-economic factors appeared to influence the prevalence and risk of ET was higher amongst slum dwellers versus non-slum population (odd ratio-2.29). Family history was positive in about one-fifth of the cases. CONCLUSION: This study has documented that the prevalence of ET above 40 years in India is similar to that of many countries globally and common amongst slum dwellers and there are fewer familial cases.

Haematological presentation of systemic lupus erythematosus.

Haematological manifestations are quite common in systemic lupus erythematosus (SLE) but bone marrow aplasia and secondary myelofibrosis are rare manifestations. We report a case of 45 years old male patient who presented with fever, malaena and anaemia without any clinical features of SLE. He had patches of vitiligo for 25 years for which he was applying psoralen with sunlight exposure. This probably precipitated SLE in this patient. The patient presented with pancytopenia which was due to a combination of Comb's positive haemolytic anaemia and myelofibrosis.

Cognitive dysfunction in an urban Indian population--some observations.

There is no prospective study of mild cognitive impairment (MCI) in India. This study aims to determine the prevalence rate of dementia and to prospectively analyze a group of patients with MCI. A door-to-door cross-sectional cluster survey was conducted in Kolkata, India, among those aged >50 years to estimate the prevalence rate of dementia. Then annual assessment of cognitive function using a validated questionnaire battery was undertaken among 21 elderly individuals with memory complaints for 4 consecutive years. A total of 53,907 persons were surveyed. The crude prevalence rates of dementia were 0.62% (95% CI 0.44-0.84) and 1.25% (95% CI 0.87-1.74) among those >50 and >60 years of age, respectively. The weighted prevalence rate among those above 50 years was 0.95% (95% CI 0.68-1.29). Alzheimer's disease was the commonest subtype (55%) followed by vascular dementia (36%). In a prospective study, MCI remained static, converted to dementia or reverted to normalcy. There was also transition from one subtype of MCI to another. A similar outcome of MCI is also noted in Western nations. However, the prevalence rate of dementia in Eastern India remained quite low.

Prevalence of major neurological disorders among geriatric population in the metropolitan city of Kolkata.

Well-conducted neuroepidemiological studies for the geriatric population are rare in India. In view of the growing aging population, we planned to determine the prevalence of common neurological disorders among the elderly population in the city of Kolkata. This was a cross-sectional study of a stratified random sample of the city population and carried in two stages through house to house survey. Initially, trained non-medical workers screened the cases with a validated family questionnaire and then a neurologist examined all the screened positive cases. A validated neuropsychological screening test was also applied among the elderly population with cognitive complaints. Results showed prevalence rates (per 1000 elderly population--> or = 60 years) of following disorders in decreasing order: stroke--33.93, essential tremor--13.76, dementia--7.89, Parkinsonism--3.30 and epilepsy--2.57. Sex-specific prevalence showed that stroke was commoner among men and that of other disorders among women. Age-specific prevalence recorded progressive increase in the rates of all disorders among both genders, though not uniformly among women. Overall the crude prevalence of neurological disorders was 60.9 per 1000. The present study shows higher rate of stroke as compared to other neurological disorders among elderly population in India, which needs urgent attention.

An epidemiologic study of mild cognitive impairment in Kolkata, India.

OBJECTIVES: To estimate the prevalence of two types of mild cognitive impairment (MCI)-amnestic and multiple domain types-among nondemented and nondepressed elderly subjects aged 50 and older. METHODS: The study was carried out in Kolkata, the eastern metropolis of India. A cross-sectional community screening was carried out, and 960 subjects were selected by systematic random sampling for the assessment of cognitive function with the help of a validated cognitive questionnaire battery administered through house-to-house survey. A case-control study was also undertaken to identify potential risk factors through univariate analysis. RESULTS: Ultimately, full evaluation of cognitive function was possible in 745 of 960 subjects. An overall prevalence of MCI detected based on neuropsychological testing was 14.89% (95% CI: 12.19 to 17.95). Prevalence of the amnestic type was 6.04% (95% CI: 4.40 to 8.1) and that of the multiple domain type was 8.85% (95% CI: 6.81 to 11.32). Adjusted for age, education. and gender, the amnestic type was more common among men and the multiple domain type among women with advancement of age. Rates differed considerably with educational attainment. Hypertension and diabetes mellitus were the major risk factors for both types of MCI. CONCLUSION: In this first community-based study of mild cognitive impairment (MCI) from India, prevalence of the amnestic type is comparable with and that of the multiple domain type is less than the prevalence in developed countries. Variations in age, education, and gender specific prevalence of MCI of both types were encountered. The putative risk factors identified merit further study.

A random sample survey for prevalence of major neurological disorders in Kolkata.

BACKGROUND & OBJECTIVES: Large scale epidemiological studies on neurological disorders are very few in India. We therefore planned to conduct a cross-sectional population-based epidemiological study on a stratified randomly selected sample from the city of Kolkata to study the prevalence of major neurological disorders such as epilepsy, stroke, dementia and Parkinsonism. METHODS: The method of case ascertainment was two- stage house-to-house survey; the first stage was undertaken by a field team consisting of four field workers and a neuropsychologist. Screening questionnaire based on National Institute of Mental Health and Neuro Sciences (NIMHANS) protocol was used. In the second stage a neurologist examined all the screened positive cases. RESULTS: A total of 52,377 subjects participated in the study. The crude prevalence rates (per 100,000 population) of major neurological disorders with 95 per cent confidence intervals (95% CI) and age adjusted rates (AAR) based on US 2000 population were 557.5 (95% CI 496.17-624.40 and AAR - 516.77) in epilepsy, 486.85 (95% CI 377.0 to 551.11 and AAR-765.68) in stroke, 87.82 (95% CI 64.02-117.50 and AAR-168.4) in dementia and 45.82 (95% CI 29.64-67.63 and AAR-71.64) in Parkinsonism. The weighted prevalence rates (per 100,000) of the whole population based on re-screening of 10 per cent of negative samples were 763.89 (95% CI 690.55- 842.57) in epilepsy, 624.32 (95% CI 555.64-699.24) in stroke and 139.37 (95% CI 108.71-176.06) in dementia. INTERPRETATION & CONCLUSION: A high rate of stroke and overall lower prevalence of Parkinsonism and dementia was recorded as compared to western studies. High prevalence rate of stroke emphasizes the need to study incidence, morbidity and mortality profile of stroke including its socio-economic impact and also case-control analysis to determine the underlying risk factors.

Aicardi syndrome: a report of five Indian cases.

Five Indian cases of Aicardi syndrome, aged 1-13 years and all with the classic triad of infantile spasm, corpus callosal agenesis and chorioretinal lacunae, were presented. The purpose of this report was to demonstrate the clinical, electroencephalographic (EEG) and radiological spectrum and the treatment outcome of this disorder among the Indians. None of the patient had any family history of similar illness. All had profound psychomotor impairment with no meaningful speech development. There were microphthalmia in 2, optic disc coloboma in 1, interhemispheric cyst in 1, periventricular heterotopia in 2 and thoracolumbar kyphoscoliosis in 2 cases. They all had early onset epilepsy and there were multiple types of seizures. Two cases (40%) had the characteristic dissociated burst-suppression pattern in EEG. Two cases whose antiepileptic medications included vigabatrin had complete control of seizure.